Dissemination and Implementation Roundtable

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  • 1. Welcome to PCORI Please be seated by 8:50 AM. The webinar will go live at 9 AM.
  • 2. #PCORI Welcome Hello and welcome to PCORI’s roundtable The goal for today is to obtain input to help PCORI develop a project for development of the PCORI Action Plan for Dissemination and Implementation Thank you for joining us 2PCORI's Blueprint for a Dissemination and Implementation Action Plan
  • 3. #PCORI Information for Roundtable Participants We have numerous webinar participants who are joining us online and telephone, so please state your name and title before speaking Restrooms are located outside near the elevators. You will need to stop by the front desk for a key fob to use the restroom and to get back into PCORI Please use your name tents to let the moderator know that you are interested in speaking by standing them up when you would like to speak 3PCORI's Blueprint for a Dissemination and Implementation Action Plan
  • 4. Dissemination and Implementation Roundtable July 29, 2013
  • 5. #PCORI Moderator Ayodola Anise, MHS Senior Program Associate Addressing Disparities Ayodola Anise, MHS, supports the Health Disparities research priority area and the Methodology Committee. She joins PCORI from the Engelberg Center for Health Care Reform at Brookings, where she managed activities related to the Quality and Equity/Disparities Initiatives. Her work there focused on informing regional, state, and national practices on performance measurement, specifically addressing data collection, data integration/aggregation, patient-centered measurement, and vulnerable populations. PCORI's Blueprint for a Dissemination and Implementation Action Plan 5
  • 6. #PCORI Information for Webinar Participants Webinar participants may answer the discussion questions online at: http://pcori.org/events/dissemination-and- implementation-roundtable/ Email: implementation@pcori.org Twitter: #pcori The webinar “chat” feature Public Comment Period is 4:15 – 4:45 PM (ET) The prompts for public comment will be made available through July 31, 2013 at 5 PM (ET) 6PCORI's Blueprint for a Dissemination and Implementation Action Plan
  • 7. #PCORI 7 Overview Establishing PCORI’s Blueprint for a Dissemination and Implementation Action Plan 1 2 3 4 5 6 Welcome and Introductions Overview of Dissemination and Implementation Overview of AHRQ’s Dissemination and Implementation Efforts Roundtable Discussion - Part 1: Questions 1, 2, and 3 Roundtable Discussion - Part 2: Questions 4, 5, and 6 Public Comment Period 7 Next Steps and Adjourn Break Break PCORI's Blueprint for a Dissemination and Implementation Action Plan
  • 8. #PCORI Welcome: 9:00 am – 9:30 am Anne C. Beal, MD, MPH Deputy Executive Director Chief Officer for Engagement A pediatrician and public health specialist, Anne C. Beal, MD, MPH, has devoted her career to providing access to high- quality health care. As PCORI’s first Chief Officer for Engagement, she will work to ensure the voices of patients and other stakeholders are reflected in our growing research portfolio. In her previous role as Chief Operating Officer, she worked to ensure PCORI develops the structure and capacity needed to carry out its mission as the nation’s largest research institute focused on patient-centered outcomes research. She joined PCORI from the Aetna Foundation, the independent charitable and philanthropic arm of Aetna Inc. She holds a BA from Brown University, an MD from Cornell University Medical College, and an MPH from Columbia University. 8PCORI's Blueprint for a Dissemination and Implementation Action Plan
  • 9. #PCORI About Us An independent non-profit research organization authorized by Congress as part of the 2010 Patient Protection and Affordable Care Act (PPACA) Committed to continuously seeking input from patients and a broad range of stakeholders to guide our work PCORI's Blueprint for a Dissemination and Implementation Action Plan 9
  • 10. #PCORI Our Mission and Vision Mission The Patient-Centered Outcomes Research Institute (PCORI) helps people make informed health care decisions, and improves health care delivery and outcomes, by producing and promoting high integrity, evidence-based information that comes from research guided by patients, caregivers and the broader health care community. Vision Patients and the public have the information they need to make decisions that reflect their desired health outcomes. PCORI's Blueprint for a Dissemination and Implementation Action Plan 10
  • 11. #PCORI Our Core Duties Establish national research priorities Establish and carry out a research agenda Develop and update methodological standards Disseminate research findings PCORI's Blueprint for a Dissemination and Implementation Action Plan 11
  • 12. #PCORI PCORI's Blueprint for a Dissemination and Implementation Action Plan 12 Our Board of Governors Represents the Entire Healthcare Community PCORI Board of Governors, March 2012 in Baltimore, MD This is really low resolution. Do we have better quality?
  • 13. #PCORI 13 PCORI’s Vision for Dissemination and Implementation PCORI's Blueprint for a Dissemination and Implementation Action Plan
  • 14. #PCORI The Case for Addressing the Implementation Gap Research + Practice Optimal Healthcare Delivery PCORI’s Blueprint for Dissemination and Implementation Targets the Gap Current Knowledge and Practice New Investments in Knowledge Implementation Gap to Improve Practice 14PCORI's Blueprint for a Dissemination and Implementation Action Plan
  • 15. #PCORI Clinicians frequently use general Internet searches and colleagues to obtain information to diagnose and treat patients How often do you use the following sources to obtain information to diagnose, treat and care for patients? 15 40% 38% 34% 20% 18% 4% 31% 28% 28% 40% 35% 13% 0% 20% 40% 60% 80% 100% General internet search engines Online subscription services Colleagues Online free services Peer reviewed literature Cochrane Database or other systematic reviews Daily A few times per week PCORI's Blueprint for a Dissemination and Implementation Action Plan
  • 16. #PCORI 6% 27% 34% 32% 2% 11% 26% 60% 0% 20% 40% 60% 80% 100% Other source Family or friends Doctor or health care provider Internet Chronic Disease Patients Rare Disease Patients Patients use the Internet as first source of health information The most recent time you looked for information about health or medical topics, where did you go first? *p <0.05 16PCORI's Blueprint for a Dissemination and Implementation Action Plan
  • 17. #PCORI Patients use a variety of Internet sources In the past 12 months, which of the following internet sources have you used to get information about health or medical topics? 17 42% 54% 47% 45% 37% 36% 34% 37% 0% 20% 40% 60% 80% 100% Website for disease focused group Website for government health agency Website for health plan Patient online community Chronic Disease Patients Rare Disease Patients *p <0.05 * * * PCORI's Blueprint for a Dissemination and Implementation Action Plan
  • 18. #PCORI Patients’ trust in Internet is low compared to other sources How much do you trust information about health or medical topics from each of the following? 18 23% 21% 20% 23% 24% 41% 69% 12% 13% 13% 15% 20% 40% 76% 0% 20% 40% 60% 80% 100% Online patient communities Family or friends Internet Your health plan Government health agencies Disease focused groups Doctor % “A lot” of trust Chronic Disease Patients Rare Disease Patients *p <0.05 * * * * PCORI's Blueprint for a Dissemination and Implementation Action Plan
  • 19. #PCORI Establishing a PCORI Blueprint for the Dissemination and Implementation Action Plan PCORI’s Blueprint for Dissemination and Implementation is being established:  To guide the organization in disseminating the research findings of funded research conducted in the national program areas  To speed implementation by actively facilitating how PCORI’s research findings can be used by healthcare decision makers  To evaluate how the effect of the dissemination of such findings reduces practice variation and disparities in health care PCORI's Blueprint for a Dissemination and Implementation Action Plan 19 DISSEMINATION IMPLEMENTATION+
  • 20. #PCORI Potential Mechanisms for Dissemination and Implementation 20 DISSEMINATION IMPLEMENTATION+ Engage major patient organizations Establish partnerships with specialty organizations; Build working relationships with health plans; Develop partnerships with health systems; Connect with the National Patient-Centered Clinical Research Network; Publish findings in key journals; and Explore use of web services, social media, apps, etc. PCORI's Blueprint for a Dissemination and Implementation Action Plan
  • 21. #PCORI AHRQ and PCORI’s Role in Dissemination and Implementation 21 Authorizing Legislation AHRQ shall disseminate the research findings that are published by PCORI Sec. 937(a)(1) Create informational tools that organize and disseminate research findings for physicians, health care providers, patients, payers, and policy makers Sec. 937(a)(1) Develop a publicly available resource database that collects and contains government-funded evidence and research Sec. 937(a)(1) The purpose of the Institute is to assist patients, clinicians, purchasers, and policy-makers in making informed health decisions by advancing the quality and relevance of evidence…and the dissemination of research findings with respect to the relative health outcomes, clinical effectiveness, and appropriateness of the medical treatments, services, and items described in subsection (a)(2)(B). Success for PCORI and AHRQ = Impact on practice and patient outcomes PCORI's Blueprint for a Dissemination and Implementation Action Plan Agency for Healthcare Research and Quality (AHRQ) Patient- Centered Outcomes Research Institute (PCORI)
  • 22. #PCORI PCORTF Distribution 22PCORI's Blueprint for a Dissemination and Implementation Action Plan Agency for Healthcare Research and Quality Patient-Centered Outcomes Research Institute Office of Secretary, Health and Human Services 4% Patient Centered Outcomes Research Trust Fund (PCORTF) Patient Centered Outcomes Research Trust Fund (PCORTF) 16% 80%
  • 23. #PCORI 3 Goals: PCORI’s Blueprint for a Dissemination and Implementation Action Plan PCORI's Blueprint for a Dissemination and Implementation Action Plan 23 1. Gather opinions from experts on what PCORI’s blueprint should encompass 2. Identify gaps where there is a need to develop new knowledge on best practices for dissemination & implementation 3. Grow consensus behind an approach to our work in dissemination and implementation
  • 24. #PCORI Items PCORI Will Explore at a Later Date Peer-review Public comment Aspects of scholarly publishing The requirement that we make our research results available to clinicians, patients and the general public within 90 days “after the conduct or receipt of research findings” PCORI's Blueprint for a Dissemination and Implementation Action Plan 24
  • 25. #PCORI Developing the PCORI Dissemination and Implementation Action Plan 25 Process for Developing PCORI’s Blueprint for Dissemination and Implementation Action Plan Incorporate learning from workshop and develop PCORI Action Plan for Dissemination and Implementation Host D & I Roundtable Convene experts at D & I Roundtable to receive input which will inform RFP Conduct Phone Calls Collect preliminary information from roundtable participants Release RFP or RFPs Award RFP or RFPsHost D & I WorkshopFINAL: PCORI D & I Action Plan JULY 2013 Using input from the roundtable, develop and release an RFP or a series of RFPs Award RFP or RFPs to finalists for development of background materials Convene D & I Workshop to hear results of project(s) RFP AUGUST 2013 OCTOBER 2013FEBRUARY 2014FEBRUARY 2014 PCORI's Blueprint for a Dissemination and Implementation Action Plan
  • 26. #PCORI Conflict of Interest Roundtable participants will not be barred from participating in funding opportunities or service agreements. The roundtable is open to the public for others to listen in on the deliberations via call-in teleconference. 26PCORI's Blueprint for a Dissemination and Implementation Action Plan
  • 27. #PCORI 27 Question and Answer PCORI's Blueprint for a Dissemination and Implementation Action Plan
  • 28. #PCORI Moderator Ayodola Anise, MHS Senior Program Associate Addressing Disparities Ayodola Anise, MHS, supports the Health Disparities research priority area and the Methodology Committee. She joins PCORI from the Engelberg Center for Health Care Reform at Brookings, where she managed activities related to the Quality and Equity/Disparities Initiatives. Her work there focused on informing regional, state, and national practices on performance measurement, specifically addressing data collection, data integration/aggregation, patient-centered measurement, and vulnerable populations. PCORI's Blueprint for a Dissemination and Implementation Action Plan 28
  • 29. #PCORI Participants Gail Hunt National Alliance for Caregiving Gail Hunt is President and CEO of the National Alliance for Caregiving, located in Bethesda. The Alliance is a diverse coalition of national organizations that seeks to advocate for and serve as a research and training resource for family caregivers of patients/consumers across the lifespan. She was a member of the Policy Committee of the 2005 White House Conference on Aging. She has been active in many national and international conferences on family caregiving and also helped to develop an international coalition of caregiving groups. She received her BA from Columbia University. 29PCORI's Blueprint for a Dissemination and Implementation Action Plan
  • 30. #PCORI Participants Sharon Levine, MD The Permanente Medical Group of Northern California Sharon Levine, MD, has been Associate Executive Medical Director for The Permanente Medical Group of Northern California since 1991. She is responsible for the recruitment, compensation, clinical education, management training, and leadership development for the group’s physicians; government and community relations; health policy and external affairs; and pharmacy policy and drug use management. A board-certified pediatrician, she has practiced with The Permanente Medical Group since 1977. A native of Boston, she received her undergraduate degree from Radcliffe College at Harvard University and her medical degree from Tufts University School of Medicine. 30PCORI's Blueprint for a Dissemination and Implementation Action Plan
  • 31. #PCORI We Want to Hear From You Current Knowledge and Practice New Investments in Knowledge Implementation Gap to Improve Practice 31PCORI's Blueprint for a Dissemination and Implementation Action Plan Today’s webinar participants can provide input via: Email: implementation@pcori.org Twitter: #pcori The webinar “chat” feature Answer the discussion questions online: http://pcori.org/events/dissemination-and- implementation-roundtable
  • 32. #PCORI Participants Craig Acomb, MS Institute for Clinical Systems Improvement/Health Partners Craig Acomb, MS, serves as Chief Operating Officer and Chief Science Officer for the Institute for Clinical Systems Improvement (ICSI). Previously, he was the Assistant Commissioner and COO for the Minnesota Department of Health (MDH), where he oversaw the operations and administration of a broad portfolio of public health programs and the agency’s 1,500 employees. His duties included organizational leadership, business direction and financial oversight, policy development, strategic and operational planning, workforce development, corporate communications, and government relations. From 2007 to 2009, he served as MDH’s Chief Financial Officer. 32PCORI's Blueprint for a Dissemination and Implementation Action Plan
  • 33. #PCORI Participants Hilda Bastian National Center for Biotechnology Information Hilda Bastian works at the National Center for Biotechnology Information (NCBI) at the National Institutes of Health in Bethesda. She is responsible for improving accessibility and usability of National Library of Medicine (NLM) resources based on systematic reviews, particularly the development of PubMed Health, a new NLM website. Before moving to the United States, she was the head of the Health Information Department at the German Institute for Quality and Efficiency in Health Care in Cologne, producing a bilingual evidence- based website for patients and consumers. Prior to that, she had been a health consumer advocate in Australia and internationally for over 20 years. She was the chairperson for several years of the Consumers Health Forum of Australia. PCORI's Blueprint for a Dissemination and Implementation Action Plan 33
  • 34. #PCORI Participants Kathleen Blake, MD, MPH American Medical Association Kathleen Blake, MD, MPH, is Vice President of the Physician Consortium for Performance Improvement® (PCPI®) convened by the American Medical Association. She ensures the successful execution of all components of the PCPI strategic direction, the integrity of its measure portfolio, and the expeditious development of the recently established PCPI Foundation. She is a clinical cardiac electrophysiologist who earned her medical degree from the University of Chicago, followed by internship, residency, and fellowship training in internal medicine and cardiovascular diseases at Stanford University. In 2011, she earned an MPH from Johns Hopkins Bloomberg School of Public Health. PCORI's Blueprint for a Dissemination and Implementation Action Plan 34
  • 35. #PCORI Participants Barbara Edson, RN, MBA, MHA American Hospital Association Barbara Edson, RN, MBA, MHA is Vice President of Clinical Quality at HRET and assisted with leadership for the AHRQ- funded On the CUSP: Stop BSI national project, including developing and leading national neonatal project to prevent CLABSI. Currently, she is the Project Director for the AHRQ- funded On the CUSP: Stop CAUTI national project, TeamSTEPPS National Training Center Contract, the TeamSTEPPS Medical Office Contract and the AHA/NPSF Comprehensive Patient Safety Leadership Fellowship. She is a Master TeamSTEPPS trainer and has been a state Baldrige examiner. She has a BSN from Marquette University, an MBA/MHA from Pfeiffer University, and has completed Patient Safety Officer training at IHI and obtained Just Culture Certification from Outcome Engenuity. 35PCORI's Blueprint for a Dissemination and Implementation Action Plan
  • 36. #PCORI Participants Kevin Fahey, MS America’s Health Insurance Plans Kevin Fahey is Executive Director in the Clinical Affairs Department of America’s Health Insurance Plans (AHIP). With AHIP, he has played a leadership role in several projects involving research data networks, including the Vaccine Safety Datalink, the Post-Licensure Rapid Immunization Safety Monitoring project for the H1N1 vaccine, and a number of other public health and safety initiatives. He also serves as the AHIP lead for the FDA Mini-Sentinel and was involved in the development of the initiative. He has worked in health and public policy research for over 25 years and holds a master’s degree in science and technology policy from George Washington University and a bachelor’s degree in government and sociology from Colby College. PCORI's Blueprint for a Dissemination and Implementation Action Plan 36
  • 37. #PCORI Participants Tejal Gandhi, MD, MPH National Patient Safety Foundation Tejal Gandhi, MD, MPH, is President of the National Patient Safety Foundation. In this role, she is advocating patient safety at the national level, driving educational and certification efforts, and helping create and spread innovative new safety ideas. She was formerly the Executive Director of Quality and Safety at Brigham and Women’s Hospital, and Chief Quality and Safety Officer at Partners Healthcare. In these roles, she has led the efforts to standardize and implement patient safety best practices across hospital and health systems. She won the 2009 John M. Eisenberg award. She is a board-certified internist and Associate Professor of Medicine at Harvard Medical School. She received her MD and MPH from Harvard Medical School and the Harvard School of Public Health. 37PCORI's Blueprint for a Dissemination and Implementation Action Plan
  • 38. #PCORI Participants Don Goldmann, MD Institute for Healthcare Improvement Don Goldmann, MD, is the Chief Medical and Scientific Officer for the Institute for Healthcare Improvement (IHI). He works both internally and externally to deepen IHI’s profile, credibility, and influence in health care and health promotion. He also serves as senior lead for the IHI Fellowship Program, and he continues to train and mentor emerging investigators at Harvard Medical School, Boston Children’s Hospital, and the Harvard School of Public Health. He is also Clinical Professor of Pediatrics at Harvard Medical School, as well as Professor of Immunology and Infectious Diseases and Epidemiology at the Harvard School of Public Health. 38PCORI's Blueprint for a Dissemination and Implementation Action Plan
  • 39. #PCORI Participants Jennifer Graff, PharmD National Pharmaceutical Council Jennifer Graff, PharmD, is the National Pharmaceutical Council’s (NPC) director of comparative effectiveness research. Dr. Graff works to advance NPC's comparative effectiveness research (CER) and evidence-based medicine policy research initiatives assessing the methods, interpretation and application of CER. Prior to MedImmune, she held several positions at the Pfizer Pharmaceuticals Group, most recently as the associate director for worldwide outcomes research. Jennifer holds a Doctorate of Pharmacy from the University of Nebraska Medical Center, and completed a Health Outcomes and Pharmacoeconomics fellowship at the University of Michigan. 39PCORI's Blueprint for a Dissemination and Implementation Action Plan
  • 40. #PCORI Participants Matthew Holland WebMD Matthew Holland leads WebMD and Medscape’s focused efforts in online education and media serving the US government and the world’s leading pharmaceutical and medical device companies. He oversees the creation of marketing and support materials and directs WebMD and Medscape’s government relations activities with US federal agencies, the administration, and members of Congress. 40PCORI's Blueprint for a Dissemination and Implementation Action Plan
  • 41. #PCORI Participants Bob Jesse, MD, PhD US Department of Veterans Affairs Bob Jesse, MD, PhD, was appointed Principal Deputy Under Secretary for Health in the Department of Veterans Affairs (VA) on July 4, 2010. In this position, he leads clinical policies and programs for the Veterans Health Administration (VHA). He received his bachelor of science degree in biochemistry from the University of New Hampshire. Later he earned his PhD in biophysics at the Medical College of Virginia, followed by his MD. 41PCORI's Blueprint for a Dissemination and Implementation Action Plan
  • 42. #PCORI Participants Norm Kahn, MD Council of Medical Specialty Societies Norm Kahn, MD, serves as Executive Vice President and Chief Executive Officer of the Council of Medical Specialty Societies (CMSS). He represents CMSS to the Physicians Consortium for Performance Improvement (PCPI), the National Quality Forum (NQF), the National Priorities Partnership (NPP), the Ambulatory Quality Alliance (AQA), and the National Committee for Quality Assurance (NCQA). He earned his medical degree from Kansas University Medical Center in Kansas City and a bachelor of arts in English literature from the University of Pennsylvania. 42PCORI's Blueprint for a Dissemination and Implementation Action Plan
  • 43. #PCORI Participants Christine Laine, MD, MPH, FACP American College of Physicians International Committee of Medical Journal Editors Christine Laine, MD, MPH, FACP, is Editor-in-Chief of Annals of Internal Medicine and Senior Vice President of the American College of Physicians. She is board-certified in internal medicine and sees patients and teaches at Jefferson Medical College in Philadelphia. She received her medical degree from SUNY Stony Brook and completed residency at The New York Hospital (Cornell University) and fellowship in general internal medicine and clinical epidemiology at Beth Israel Hospital (Harvard University). Her master of public health degree is from Harvard University. She holds leadership positions in the International Committee of Medical Journal Editors, the Council of Science Editors, and the ethics committee of the World Association of Medical Editors. 43PCORI's Blueprint for a Dissemination and Implementation Action Plan
  • 44. #PCORI Participants Sarah Lock, JD AARP Sarah Lock, JD is AARP’s Senior Vice President for Policy. She helps develop AARP’s public policy positions addressing the major issues facing older Americans. Sarah is a member of the American Society on Aging and the National Academy of Social Insurance. She also formerly served as a Commissioner for the American Bar Association’s Commission on Law and Aging. She graduated from the University of Maryland School of Law. 44PCORI's Blueprint for a Dissemination and Implementation Action Plan
  • 45. #PCORI Participants Renee Mentnech, MS, BSN Centers for Medicare and Medicaid Services Renee Mentnech, MS, BSN, has been with the Centers for Medicare & Medicaid Services (CMS) since 1988 and has served the agency in a variety of positions, including as a Social Science Research Analyst, Special Assistant to the Office Director, and as a manager for the last 14 years. She is a nurse by training and has a graduate degree in health policy from the University of Maryland. Currently, she is the Director of the Research and Rapid Cycle Evaluations Group, Center for Medicare and Medicaid Innovation. She provides leadership and executive direction within CMS for a range of healthcare financing research activities. 45PCORI's Blueprint for a Dissemination and Implementation Action Plan No Photo Available
  • 46. #PCORI Participants Brian Mittman, PhD US Department of Veteran Affairs Brian Mittman, PhD, is Senior Advisor to the VA Center for Implementation Practice and Research Support and a senior research scientist at the Kaiser Permanente Southern California Department of Research and Evaluation. He is a member of the PCORI Methodology Committee and the Association of American Medical Colleges Advisory Panel on Research. He received a PhD in organizational behavior from the Stanford University Graduate School of Business. 46PCORI's Blueprint for a Dissemination and Implementation Action Plan
  • 47. #PCORI Participants Doris Peter, PhD Consumer Reports Doris Peter, PhD, is the Associate Director of the Consumer Reports Health Ratings Center, where she leads multidisciplinary teams that develop ratings and consumer- friendly translations and presentations of data to help consumers understand comparisons of the quality of healthcare products (e.g., drugs) and services (e.g., hospitals, insurance plans). She is the principal investigator of a grant from the Consumer and Prescriber Education Grant Project (Consumer Reports Health Best Buy Drugs) that involves translating and disseminating comparative effectiveness research into actionable advice for consumers. Prior to joining Consumer Reports, she was an editor and publisher at The Medical Letter and then North American editor for an international evidence-based medicine journal. 47PCORI's Blueprint for a Dissemination and Implementation Action Plan
  • 48. #PCORI Participants Michelle Proser, MPP National Association of Community Health Centers Michelle Proser, MPP, PhD Candidate, is the Director of Research at the National Association of Community Health Centers, where she has 10 years of experience collecting data, conducting research and analysis, and applying information to empower communities in their efforts to improve population health. She has authored and co-authored numerous publications on health centers, disparities, primary care, community health, and medical underservice. Her work also includes building health center capacity for community-directed translational research. She has presented at AcademyHealth, the National Conference of State Legislatures, the American Public Health Association, the National Institutes of Health, and other meetings. 48PCORI's Blueprint for a Dissemination and Implementation Action Plan
  • 49. #PCORI Participants Pamela Rich, MPH National Business Group on Health Pamela Rich, MPH, joined the National Business Group on Health in 2007. She is a program analyst in the Institute on Health Care Costs and Solutions. In her role, she manages the National Committee on Evidence-Based Benefit Design and translates research into employer-based strategies. She also works on projects related to employee communications and engagement and maternal and child health. Prior to her current role, she managed the Business Group’s Pharmaceutical Council and completed work on specialty pharmaceuticals and medication adherence. Additionally, she has worked on projects on cancer care, racial and ethnic health disparities, tobacco cessation, and behavioral health. She received a bachelor of arts degree in international affairs and a master of public health degree from The George Washington University. 49PCORI's Blueprint for a Dissemination and Implementation Action Plan
  • 50. #PCORI Participants Kate Ryan, MPA Consumers United for Evidence-based Healthcare National Women’s Health Network Kate Ryan, MPA, is Senior Program Coordinator at the National Women’s Health Network. In this role, she develops and implements a program of legislative and regulatory advocacy to reduce women’s exposure to unnecessary drug and medical treatment risks. As a member of the steering committee of Consumers United for Evidence-based Healthcare, she works to improve the quality of women’s health care through the use of evidence-based medicine. Previously, she worked in the Capitol Hill office of US Representative Joe Sestak on healthcare reform and women’s issues. She received her MPA from the NYU Wagner Graduate School of Public Service. PCORI's Blueprint for a Dissemination and Implementation Action Plan 50
  • 51. #PCORI Participants Bruce Seeman Agency for Healthcare Research & Quality PCORI's Blueprint for a Dissemination and Implementation Action Plan 51
  • 52. #PCORI Participants Joe Selby, MD, MPH Patient-Centered Outcomes Research Institute A family physician, clinical epidemiologist, and health services researcher, Joe Selby has more than 35 years of experience in patient care, research, and administration. He is responsible for identifying strategic issues and opportunities for PCORI and implementing and administering programs authorized by the PCORI Board of Governors. He joined PCORI from Kaiser Permanente, Northern California, where he was Director of the Division of Research for 13 years and oversaw a department of more than 50 investigators and 500 research staff members working on more than 250 ongoing studies. He was with Kaiser Permanente for 27 years. An accomplished researcher, Joe has authored more than 200 peer-reviewed articles and continues to conduct research, primarily in the areas of diabetes outcomes and quality improvement. PCORI's Blueprint for a Dissemination and Implementation Action Plan 52
  • 53. #PCORI Participants Lisa Simpson, MB, BCh, MPH, FAAP AcademyHealth Lisa Simpson, MB, BCh, MPH, FAAP, is President and Chief Executive Officer of AcademyHealth. A nationally recognized health policy researcher and pediatrician, she is a passionate advocate for the translation of research into policy and practice. Since joining AcademyHealth in 2011, she has worked to raise the visibility of the field of health services research and its contributions to improving the quality, value, and accessibility of care; reducing disparities; and improving health. 53PCORI's Blueprint for a Dissemination and Implementation Action Plan
  • 54. #PCORI Participants Jamie Skipper, PhD, RN US Department of Health and Human Services Office of the National Coordinator for Health Information Technology (ONC) Jamie Skipper, PhD, RN, is currently Lead Analyst working on priority-setting activities for ONC and HHS regarding patient- centered outcomes research. She has also served as the coordinator for the Standards & Interoperability Framework within ONC at HHS. Prior to ONC, she was a policy consultant to EHR vendors, after serving on Capitol Hill as a healthcare advisor to Congressman Phil Gingrey (focusing on health IT policy) and after serving as a Grants Program Officer at NHLBI. She was also a Policy Fellow at the IOM’s Evidence-Based Medicine Roundtable. She has a PhD in cardiac physiology and is a registered nurse. 54PCORI's Blueprint for a Dissemination and Implementation Action Plan No Photo Available
  • 55. #PCORI Participants Jean Slutsky, PA, MSPH Agency for Healthcare Research & Quality Jean Slutsky, PA, MSPH, has directed the Center for Outcomes and Evidence, Agency for Healthcare Research and Quality (AHRQ) of the US Department of Health and Human Services, since June 2003. She is also a member of the AcademyHealth Methods Council and a member of the Methodology Committee of PCORI. She received her bachelor of science degree at the University of Iowa, a master’s of science in public health from the University of North Carolina at Chapel Hill, and trained as a physician assistant at the University of Southern California. 55PCORI's Blueprint for a Dissemination and Implementation Action Plan
  • 56. #PCORI Participants Roger Snow, MD, MPH Medicaid Medical Directors Learning Network Roger Snow, MD, MPH, is the Deputy Medical Director for Medical Policy in the Office of Clinical Affairs of the Office of Medicaid in the Executive Office of Health and Human Services, Commonwealth of Massachusetts. Prior to his service in Medicaid, he practiced medicine at Massachusetts General Hospital for 20 years. He has recently served on the New England Comparative Effectiveness Public Advisory Council (CEPAC) and is presently a member of the CEPAC Advisory Board. He attended medical school at the University of North Carolina, Chapel Hill, and trained in medicine and pathology in Boston. He holds a degree in public health from Harvard. 56PCORI's Blueprint for a Dissemination and Implementation Action Plan
  • 57. #PCORI Participants Darius Tandon, PhD Johns Hopkins University Darius Tandon, PhD, is Associate Professor in the Division of General Pediatrics and Adolescent Medicine at Johns Hopkins University School of Medicine. Trained as a community psychologist, he has a long-standing interest in the science and practice of incorporating community and patient perspectives into the research process and clinical care. He is Director of the Community Engagement Core of the Clinical and Translational Science Award at Johns Hopkins, where he has been the architect of several activities and programs to promote the practice of community-university partnerships throughout the research trajectory. He also serves as the Editor-in-Chief of Progress in Community Health Partnerships, the only peer- reviewed academic journal solely focused on community-based participatory research. 57PCORI's Blueprint for a Dissemination and Implementation Action Plan
  • 58. #PCORI Participants Daniel Wolfson, MHSA ABIM Foundation Daniel Wolfson, MHSA, is Executive Vice President and COO of the ABIM Foundation. Previously, he served for nearly two decades as the founding president and CEO of the Alliance of Community Health Plans (formerly The HMO Group), the nation’s leading association of not-for-profit and provider- sponsored health plans. During his tenure, he earned national recognition for spearheading the development of the Health Plan Employer Data and Information Set (HEDIS™), convening the RxHealthValue coalition to provide independent information on the pharmaceutical industry, and co-sponsoring with the American College of Physicians the journal Effective Clinical Practice. He received his master's degree in health sciences administration from the University of Michigan, School of Public Health. 58PCORI's Blueprint for a Dissemination and Implementation Action Plan
  • 59. #PCORI We Want to Hear From You Current Knowledge and Practice New Investments in Knowledge Implementation Gap to Improve Practice 59PCORI's Blueprint for a Dissemination and Implementation Action Plan Today’s webinar participants can provide input via: Email: implementation@pcori.org Twitter: #pcori The webinar “chat” feature Answer the discussion questions online: http://pcori.org/events/dissemination-and- implementation-roundtable
  • 60. #PCORI Overview of Dissemination and Implementation 10:15 am – 11:15 am 60 minutes 60PCORI's Blueprint for a Dissemination and Implementation Action Plan
  • 61. Dissemination and Implementation in Health: Policy, Practice, Research Brian S. Mittman, PhD July 29, 2013
  • 62. The implementation imperative PCORI aims to improve healthcare and public health quality and outcomes via research Improvement (PCORI’s impact, benefits) requires appropriate use (adoption, implementation) of PCORI findings Research findings are not self-implementing; explicit efforts to facilitate implementation are needed Implementation is challenging PCORI's Blueprint for a Dissemination and Implementation Action Plan 62
  • 63. Our plan Overall plan: design a blueprint to guide PCORI’s D&I infrastructure and activities (individually, with AHRQ, and with -- or via -- other stakeholders) Process to develop this plan: collaborate with key stakeholders (roundtable, workshop) and contractors to 1. Identify and understand barriers to implementation and available strategies to address them 2. Determine required D&I infrastructure, activity 3. Inventory existing infrastructure and activity – and gaps 4. Design PCORI activities to fill key gaps PCORI's Blueprint for a Dissemination and Implementation Action Plan 63
  • 64. Developing PCORI’s D&I Blueprint PCORI's Blueprint for a Dissemination and Implementation Action Plan 64
  • 65. Developing PCORI’s D&I Blueprint AHRQ PCORI's Blueprint for a Dissemination and Implementation Action Plan 65
  • 66. Developing PCORI’s D&I Blueprint AHRQ Other Federal PCORI's Blueprint for a Dissemination and Implementation Action Plan 66
  • 67. Developing PCORI’s D&I Blueprint AHRQ Other Federal Private Sector PCORI's Blueprint for a Dissemination and Implementation Action Plan 67
  • 68. Developing PCORI’s D&I Blueprint AHRQ Other Federal Private Sector PCORI PCORI's Blueprint for a Dissemination and Implementation Action Plan 68
  • 69. Developing PCORI’s D&I Blueprint AHRQ Other Federal Private Sector PCORI PCORI facilitated PCORI's Blueprint for a Dissemination and Implementation Action Plan 69
  • 70. Our plan Overall plan: design a blueprint to guide PCORI’s D&I infrastructure and activities (individually, with AHRQ, and with -- or via -- other stakeholders) Process to develop this plan: collaborate with key stakeholders (roundtable, workshop) and contractors to 1. Identify and understand barriers to implementation and available strategies to address them 2. Determine required D&I infrastructure, activity 3. Inventory existing infrastructure and activity – and gaps 4. Design PCORI activities to fill key gaps PCORI's Blueprint for a Dissemination and Implementation Action Plan 70
  • 71. Key terms in D&I in health (per Lomas) Diffusion: unplanned, uncontrolled, passive flow (spread) of information; “let it happen” Dissemination: intentional, active communication and distribution of information to increase awareness, often targeting and tailoring the communication to specific audiences; “help it happen” Implementation: intentional, active communication of information and additional actions to overcome barriers to achieve use of the information; “make it happen” Source: Lomas J. Diffusion, dissemination, and implementation: who should do what? Ann NY Acad Sci. 993;703:226-35. PCORI's Blueprint for a Dissemination and Implementation Action Plan 71
  • 72. The Tower of Babel problem in D&I Knowledge translation  knowledge translation and exchange  knowledge-to-action  knowledge transfer  translating research into practice (policy and practice) Research utilization, knowledge utilization Technology transfer Knowing-doing gap T1 - T2; T1 - T2 - T3; T1 - T2 - T3 - T4 - T5 PCORI's Blueprint for a Dissemination and Implementation Action Plan 72
  • 73. Identify and understand barriers to implementation and available strategies to address them Barriers: numerous, diverse, variable (across time and place) Strategies: numerous, diverse, highly variable (across time and place) in operation and impacts, often uncontrollable “It depends” PCORI's Blueprint for a Dissemination and Implementation Action Plan 73
  • 74. Identify and understand barriers to implementation and available strategies to address them PCORI's Blueprint for a Dissemination and Implementation Action Plan 74
  • 75. The implementation quandary, conventional wisdom Dissemination and implementation are critical to achieve research impact and benefit Implementation (practice change) is remarkably difficult; practice inertia is considerable; quality and implementation gaps are incredibly resilient Barriers to practice change – and strategies to overcome them – remain poorly understood; more research is needed to discover the “keys to success” (i.e., effective implementation strategies) PCORI's Blueprint for a Dissemination and Implementation Action Plan 75
  • 76. The implementation quandary, conventional wisdom Dissemination and implementation are critical to achieve research impact and benefit Implementation (practice change) is remarkably difficult; quality and implementation gaps are incredibly resilient Barriers to practice change – and strategies to overcome them – remain poorly understood; more research is needed to discover the “keys to success” (i.e., effective implementation strategies) PCORI's Blueprint for a Dissemination and Implementation Action Plan 76
  • 77. The implementation quandary, an alternative view Dissemination and implementation are critical to achieve research impact and benefit Implementation (practice change) is remarkably difficult; quality and implementation gaps are incredibly resilient Barriers to practice change are reasonably well understood; strategies to overcome these barriers are numerous and reasonably well-known We have the knowledge but lack the will and/or ability to apply this knowledge PCORI's Blueprint for a Dissemination and Implementation Action Plan 77
  • 78. I. Factors influencing implementation II. Implementation strategies and necessary- but-sufficient conditions for practice change III. Multi-level framework Frameworks to guide D&I thinking PCORI's Blueprint for a Dissemination and Implementation Action Plan 78
  • 79. Framework I: Factors influencing implementation 1. Features of innovations, evidence 2. Features of target adopters 3. Features of the setting, environment 4. Features of innovation champions 5. Features of implementation strategies PCORI's Blueprint for a Dissemination and Implementation Action Plan 79
  • 80. Diffusion of innovations theory Benefits Relevance Feasibility Adoptability Factor 1: Innovation features (perceived) PCORI's Blueprint for a Dissemination and Implementation Action Plan 80
  • 81. Resources and capability for adoption, e.g., Staffing, skill, time, space, equipment, funds Motivation, internal incentives, culture/norms, leadership Factor 2: Features of target adopters (internal context) PCORI's Blueprint for a Dissemination and Implementation Action Plan 81
  • 82. External pressure, expectations, mandates (normative, regulatory) Incentives, rewards Resources, support Professional, community norms Factor 3: Environment, outer context PCORI's Blueprint for a Dissemination and Implementation Action Plan 82
  • 83. Most innovations require a dedicated entity to encourage, guide and support adoption The innovation champion must possess appropriate resources, capacity and skill, respect and influence, etc. Factor 4: Innovation champions PCORI's Blueprint for a Dissemination and Implementation Action Plan 83
  • 84. Communication to achieve awareness – and desired interpretation and understanding of benefits, requirements Technical assistance, tools and resources Address gaps in presence of the critical necessary but not sufficient conditions for implementation success Factor 5: Implementation strategy PCORI's Blueprint for a Dissemination and Implementation Action Plan 84
  • 85. Framework II: Conditions for practice change (necessary but not sufficient) Valid, relevant, accepted evidence (Factor 1) Knowledge, skill (Factor 2) Evidence of quality/implementation gaps (Factor 2) Requisite logistics, resources (Factor 2) External expectations, pressure (Factor 3) Supportive professional norms (Factor 3) Facilitation, technical assistance (Factor 4) Implementation gap etiology, planning (Factor 5) PCORI's Blueprint for a Dissemination and Implementation Action Plan 85
  • 86. Framework III: Multi-level influences on implementation Source: Taplin & Rodgers, 2010 PCORI's Blueprint for a Dissemination and Implementation Action Plan 86
  • 87. Framework III: Multi-level influences on implementation PCORI's Blueprint for a Dissemination and Implementation Action Plan 87
  • 88. Limitations of typical implementation efforts PCORI's Blueprint for a Dissemination and Implementation Action Plan 88
  • 89. Limitations of typical implementation efforts PCORI's Blueprint for a Dissemination and Implementation Action Plan 89
  • 90. Implications for D&I blueprint: Factor 1, innovation features (perceived) Desired features of research findings – research done differently – are important and necessary but not sufficient All research findings should be disseminated passively; many should be disseminated actively; a few should be implemented proactively; which? Benefits, impacts of engagement on adoption remain poorly understood (i.e., practice-based evidence hypothesis; engagement hypothesis) PCORI's Blueprint for a Dissemination and Implementation Action Plan 90
  • 91. Implications for D&I blueprint: Factor 2, adopter characteristics Implementation requires conducive clinician and delivery system knowledge, skill, capacity, culture, leadership, funding, motivation PCORI's Blueprint for a Dissemination and Implementation Action Plan 91
  • 92. Implications for D&I blueprint: Factor 3, environmental factors Productive environmental influences require collaboration (or alignment) with a broad range of stakeholders (regulatory, professional, industry, consumer, community) at all levels (national, regional, state, local) PCORI's Blueprint for a Dissemination and Implementation Action Plan 92
  • 93. Implications for D&I blueprint: Factor 4, innovation champions Champions (purveyors) are institutions and individuals Researchers are not suitable PCORI and AHRQ have some desired attributes Multi-stakeholder partnerships, to include target audience peers and professional associations, are optimal (ref. evidence on guideline credibility) PCORI's Blueprint for a Dissemination and Implementation Action Plan 93
  • 94. Implications for D&I blueprint: Factor 5, implementation strategy Barriers, facilitators, contextual factors, quality gaps – and their root causes – vary Implementation initiatives must be local and localized, based on root cause analyses and barrier-linked theory Implementation processes, strategies and impacts vary and are largely unpredictable; ongoing evaluation and refinement (vs. 20-20 foresight) are needed Implementation strategies are complex social interventions (i.e., highly adaptable, variable, context- dependent and directed on heterogeneous, unstable targets) PCORI's Blueprint for a Dissemination and Implementation Action Plan 94
  • 95. A few concluding thoughts on .. Implementation challenges, progress and contributions to date from research, policy and practice Implications for PCORI’s D&I Blueprint Implications for the Blueprint development process and planned contract work Implications for PCORI’s D&I research agenda PCORI's Blueprint for a Dissemination and Implementation Action Plan 95
  • 96. #PCORI 96 Question and Answer 30 minutes PCORI's Blueprint for a Dissemination and Implementation Action Plan
  • 97. #PCORI Group Photo and Lunch Break 11:15 am – 12:00 pm 45 Minutes 97 • Visit us at www.pcori.org • Follow @PCORI on Twitter • Watch our YouTube channel PCORINews PCORI's Blueprint for a Dissemination and Implementation Action Plan
  • 98. Dissemination and Implementation Roundtable Lunch break until 12:00 pm *The webinar will be muted during lunch • Visit us at www.pcori.org • Follow @PCORI on Twitter • Watch our YouTube channel PCORINews
  • 99. #PCORI Orientation to AHRQ’s Dissemination and Implementation Efforts 12:00 pm – 1:00 pm 60 minutes 99PCORI's Blueprint for a Dissemination and Implementation Action Plan
  • 100. AHRQ PCORTF ACTIVITIES: FY 2011 - Present Jean Slutsky Director, Center for Outcomes and Evidence Agency for Healthcare Research and Quality Rockville, MD
  • 101. Patient Protection and Affordable Care Act SEC. 937. DISSEMINATION AND BUILDING CAPACITY FOR RESEARCH  Allocates a portion of the PCORTF (16%) annually to AHRQ in support of programs that may: – Disseminate and translate PCOR research findings – Obtain stakeholder feedback on the value of the information to be disseminated and subsequent disseminations efforts – Assist users of Health IT to incorporate PCOR research findings into clinical practice – Provide training and career development for researchers and institutions in methods to conduct comparative effectiveness research
  • 102. PCORTF Distribution PCORTF OS HHS 4% PCORI 80% AHRQ 16%
  • 103. Importance of Stakeholders and Partnerships
  • 104. Framework for PCORTF Investments in Dissemination, Implementation and Training Evidence Synthesis HorizonScanning Patients Providers Systems and Policy Makers (e.g. CMOs, PBMs, States) Implementation (including CDS) Dissemination Translation Improvements in Health Care and Health Prioritization and Topic Development Message Development and Strategy Selection Audience Identification Data Methods Evaluation Early Career Mid-Career Institutional Infrastructure Stakeholders
  • 105. PCORTF Planning  Allocations from the PCORTF are available for expenditure through 2019  Programs are responsive to language in ACA legislation Sec. 937 in regard to purpose and use of funds in three overarching areas: – Dissemination, Translation, and Implementation – Training and Career Development – Data Methods  Build on current AHRQ efforts, while also being distinct and innovative – Investments focused on improving patient’s health, the health care system, the Triple Aim, and supporting the implementation of the ACA
  • 106. Dissemination and Implementation  Focus on dissemination and implementation research activities related to PCOR findings to: – Identify efficient and successful dissemination methods – Identify successful methods of translation for intended audiences – Identify methods for implementation of findings into practice
  • 107. Training and Career Development  Support training and development opportunities in PCOR for: – Individuals at different career stages – Institutional training opportunities that focus on applied settings – Institutions that have not previously developed expertise in PCOR training – Special emphasis on training for dissemination and implementation science
  • 108. Availability of Funds Before Sequestration  FY2011 $8M  FY2012 $24M  FY2013 $60M  FY2014 $100M
  • 109. Obligations to Date 57% 37% 6% % of Total Funds Awarded to Each Emphasis Area to Date Dissemination and Implementation Training and Career Development Data Methods
  • 110. DISSEMINATION, TRANSLATION, AND IMPLEMENTATION AWARDED AND IN PROCESS
  • 111. Dissemination, Translation, and Implementation Evidence Synthesis HorizonScanning Patients Providers Systems and Policy Makers (e.g. CMOs, PBMs, States) Improvements in Health Care and Health Prioritization and Topic Development Audience Identification Data Methods Evaluation Early Career Mid-Career Institutional Infrastructure Stakeholders Implementation (including CDS) Dissemination Translation Message Development and Strategy Selection
  • 112. Dissemination, Translation, and Implementation FY 2011 & FY 2012 - Contracts  Horizon Scanning System: Dissemination of Information on Emerging Interventions – System for searching for emerging interventions, prioritizing which are most likely to have a large impact in the near future, and disseminating the information to the public  Dissemination of timely information about emerging medical and health systems interventions – Assist stakeholders by providing critical information for decisions about planning and prioritizing research investments so that studies can be completed on the emerging interventions with the highest potential impact on the health of patients
  • 113. Dissemination, Translation, and Implementation FY 2011 & FY 2012 - Contracts  John M. Eisenberg Clinical Decisions and Communications Science Center (Eisenberg Center) – Continue the establishment and expansion of a research and translation decision science and communication center  Facilitate access to and use of evidence-based clinical and health care delivery information  Foster informed health care decisions by patients, providers, and policy makers – Apply state of the art research in decision science, communication science, and other relevant fields to ensure high impact of the Decision Science Center products on informed decision making for multiple audiences
  • 114. Sample PCOR Dissemination Products Consumer Summary Clinician Summary Tools and Resources Decision Aids English Spanish http://www.effectivehealthcare.ahrq.gov CME/CE Slide Library Research Reviews
  • 115. Dissemination, Translation, and Implementation FY 2011 & FY 2012 - Contracts  Dissemination of PCOR to Students of Health Professions – Aims to develop PCOR information tools to support educators across health care disciplines  Interviews, focus groups with health professional student associations to evaluate students’ understanding of PCOR, shared decision making  Clarify students’ educational preferences for integrating PCOR into training curricula – Project will culminate with student-focused summit  In-Store Promotion of PCOR Findings to Consumers – Promotes EHC Program materials via PSAs and giveaways in grocery stores and pharmacies  Audio announcements encourage consumers to access free EHC Program materials at store pharmacies  In ~5,000 stores nationwide  To date, more than 1 million consumer publications distributed
  • 116. Dissemination, Translation, and Implementation FY 2011 & FY 2012 - Contracts  Educating the Educators – Aims to develop EHC Program tools to help educators use PCOR information  certified health education specialists, nurses, nurse practitioners, nurses, physician assistants, medical assistants, others – Includes a baseline survey to understand PCOR awareness and information needs of educators – Tools will be implemented in “train the trainer” workshops across U.S., focusing on areas with high health disparities  Targeted Dissemination of PCOR Findings In “Stroke Belt” – Aims to promote the use of EHC Program products via multi-media campaign including print, radio, social media, billboards, Web – Encourage use of PCOR evidence in shared decision-making in stroke belt states – Emphasis on EHC Program tools related to chronic conditions
  • 117. Dissemination, Translation, and Implementation FY 2011 & FY 2012 - Contracts  Methods Center in Decision and Simulation Modeling – Develop a multidisciplinary group of experts to act as a decision and simulation modeling methods core for AHRQ programs – Develop methods guidance on modeling alongside systematic reviews, e.g. structuring decision models, model validation, communication of results – Conduct research on modeling methodology in areas of knowledge gaps and controversies in order to advance the field  Implementation of a Systematic Review Data Repository Collaborative – Web-based Systematic Review Data Repository (SRDR) for study data extracted from primary research publications during the course of conducting systematic reviews  Fully functional, open-access data system and systematic review infrastructure
  • 118. Dissemination, Translation, and Implementation FY 2013 - Contracts  Integrating PCOR into Clinical Decision Support Systems – Aims to identify steps to integrate PCOR information into clinical decision support systems on a wide scale  Project tasks include: • Consulting medical, clinical organizations to understand needs • Environmental scan and market analysis of available health information technologies • Engaging HIT vendors to understand capabilities, limitations – Project to inform future investments on incorporating PCOR information into HIT
  • 119. Dissemination, Translation, and Implementation FY 2011 & FY 2012 - Grants  Patient-Centered Outcomes Research - Dissemination by Health Professionals Associations (PCOR-DHPA) (R18) – Aimed at health professionals associations to develop dissemination programs that integrate patient-centered outcomes research into clinical practice  Eligible applicants included health professionals associations, health professionals education accrediting agencies, and health professionals licensing boards  Special emphasis on use of multi-factorial mechanisms such as education, credentialing, scientific programs, social media platforms, and other innovative methods – 3 year projects ($100,000/yr max) http://grants.nih.gov/grants/guide/rfa-files/RFA-HS-12-006.html
  • 120. Dissemination, Translation, and Implementation FY 2011 & FY 2012 - Grants  Partnerships for Sustainable Research and Dissemination of Evidence-based Medicine (R24) – Resource-related research projects to:  Build or enhance the applicants capacity to create a sustainable infrastructure for on-going dissemination of evidence-based health information  Conduct research studies that advance our knowledge of how to extend the reach and impact of evidence-based health information/tools to populations with a demonstrated need for the information – 3 year projects ($300,000/yr max) http://grants.nih.gov/grants/guide/rfa-files/RFA-HS-12-005.html
  • 121. Dissemination, Translation, and Implementation Projects in Progress  Closing the Gap in Disparities with PCOR (U18) – Identify strategies to engage stakeholders through shared decision making that can be used to effectively implement interventions specific to health care delivery systems, clinicians, and/or patients that focus on the reduction of racial/ethnic healthcare disparities in under-resourced settings.  Incorporate the translation, dissemination, and implementation of PCOR findings for racial/ethnic minority populations.  Applicants are required to demonstrate an ability to leverage the capacities of relevant and diverse stakeholders in their strategies to reduce healthcare disparities in under-resourced settings – 3 year projects ($500,000/yr max) – Application due July 31, 2013 http://grants.nih.gov/grants/guide/rfa-files/RFA-HS-13-010.html
  • 122. Dissemination, Translation, and Implementation Projects in Progress  Disseminating PCOR Evidence To Improve Healthcare Delivery (R18) – Aims to disseminate and implement existing PCOR evidence for improving the quality of health care delivery  Addresses challenges of spreading delivery system evidence by requiring applicants representing existing, multi-stakeholder networks, with: • Demonstrated history of collaborative relationships • Robust communication/dissemination/data-sharing channels, processes, & infrastructures • Knowledge of local conditions & ability to adapt to them • Experience with taking proven practices to scale – 4 year projects ($1M/yr max) – Applications due September 27, 2013 http://grants.nih.gov/grants/guide/rfa-files/RFA-HS-14-003.html
  • 123. Dissemination, Translation, and Implementation Pending Funding Opportunities  Bringing Evidence to Stakeholders for Translation (BEST) to Primary Care – Expand the current AHRQ dissemination programs to patients and providers in primary care settings – Funded projects will focus on dissemination via practice facilitation, which has been shown in controlled trials to nearly triple the adoption of evidence- based guidelines in primary care  Deliberative Approaches for Patient Involvement in Implementing Evidence-Based Health Care – Projects will use a deliberative approach, based on findings of the AHRQ Community Forum deliberative methods experiment, to gather input from patients on a complex topic related to the implementation of evidence- based health-care decision making. http://grants.nih.gov/grants/guide/notice-files/NOT-HS-13-003.html
  • 124. Dissemination, Translation, and Implementation Pending Funding Opportunities  Registry of Patient Registries (RoPR) – Build upon ongoing AHRQ investment in RoPR – Disseminate information on registries and registry- based studies – Integrated into CT.gov and stand alone https://www.fbo.gov/spg/HHS/AHRQ/DCM/AHRQ-13-10010/listing.html http://effectivehealthcare.ahrq.gov/index.cfm/search-for-guides-reviews-and-reports/?pageaction=displayproduct&productid=690
  • 125. TRAINING AND CAREER DEVELOPMENT AWARDED AND IN PROCESS
  • 126. Framework for PCOR Evidence Synthesis HorizonScanning Patients Providers Systems and Policy Makers (e.g. CMOs, PBMs, States) Implementation (including CDS) Dissemination Translation Improvements in Health Care and Health Prioritization and Topic Development Message Development and Strategy Selection Audience Identification Data Methods Evaluation Infrastructure Stakeholders Early Career Mid-Career Institutional
  • 127. Training and Career Development  Special Emphasis Notice: PCOR Mentored Career Development Grants focused on Methodologies and Research in Translation, Implementation, and Diffusion of Research into Practice and Policy – Applicable to current AHRQ-sponsored PCOR career development mechanisms (K01/K08, K12) – Will support the mentored career development of clinical and research doctorates who are interested in the development, implementation and evaluation of strategies for the translation, dissemination, and uptake of PCOR and effective clinical and system interventions. Areas of interest include:  Health Communication in PCOR  Decision Making in PCOR  Evidence Dissemination and Implementation in PCOR http://grants.nih.gov/grants/guide/notice-files/NOT-HS-13-010.html
  • 128. OPEN AND PENDING PCOR FUNDING OPPORTUNITIES - SUMMARY FY 2013
  • 129. Open Opportunities  Disseminating PCOR Evidence To Improve Healthcare Delivery (R18) (http://grants.nih.gov/grants/guide/rfa-files/RFA-HS-14-003.html)  Closing the Gap in Disparities with PCOR (U18) http://grants.nih.gov/grants/guide/rfa-files/RFA-HS-13-010.html  Registry of Patient Registries (RoPR) https://www.fbo.gov/spg/HHS/AHRQ/DCM/AHRQ-13-10010/listing.html
  • 130. Coming Soon  Bringing Evidence to Stakeholders for Translation (BEST) to Primary Care (http://grants.nih.gov/grants/guide/notice-files/NOT-HS-13-003.html)  Deliberative Approaches for Patient Involvement in Implementing Evidence-Based Health Care http://grants.nih.gov/grants/guide/notice-files/NOT-HS-13-003.html
  • 131. FY2014 PCORTF Goals  Continued emphasis on projects that: – Disseminate, translate, implement PCOR research findings – Provide training and career development for researchers and institutions in methods to conduct comparative effectiveness research – Build capacity for CER through the development of research data bases, clinical registries, and health outcomes research data networks  Special focus on transformative projects aimed at the rapidly transforming health care delivery system – 2014 marks the implementation of the ACA – Intended to show real impact  Continued investment in projects that will build upon and enhance current AHRQ sponsored PCOR investments and infrastructure
  • 132. Framework for PCORTF Investments in Dissemination, Implementation and Training Evidence Synthesis HorizonScanning Patients Providers Systems and Policy Makers (e.g. CMOs, PBMs, States) Implementation (including CDS) Dissemination Translation Improvements in Health Care and Health Prioritization and Topic Development Message Development and Strategy Selection Audience Identification Data Methods Evaluation Early Career Mid-Career Institutional Infrastructure Stakeholders
  • 133. Questions??
  • 134. #PCORI 134 Question and Answer PCORI's Blueprint for a Dissemination and Implementation Action Plan
  • 135. #PCORI Roundtable Discussion - Part 1: Questions 1, 2, and 3 1:00 pm – 2:30 pm 90 Minutes 135PCORI's Blueprint for a Dissemination and Implementation Action Plan
  • 136. #PCORI 136 Discussion Questions 1 2 3 Given your personal experience in dissemination and implementation, what are the lessons learned, barriers, and successful facilitators in dissemination and implementation? What strategies can PCORI use to build on or complement AHRQ’s current work in dissemination and implementation? What key elements would you like to see in PCORI's Blueprint to help your organization with implementing research findings? PCORI's Blueprint for a Dissemination and Implementation Action Plan
  • 137. #PCORI We Want to Hear From You Current Knowledge and Practice New Investments in Knowledge Implementation Gap to Improve Practice 137PCORI's Blueprint for a Dissemination and Implementation Action Plan Today’s webinar participants can provide input via: Email: implementation@pcori.org Twitter: #pcori The webinar “chat” feature Answer the discussion questions online: http://pcori.org/events/dissemination-and- implementation-roundtable
  • 138. #PCORI Given your personal experience in dissemination and implementation, what are the lessons learned, barriers, and facilitators in successful spread and uptake? PCORI's Blueprint for a Dissemination and Implementation Action Plan 138 1
  • 139. #PCORI What strategies can PCORI use to build on or complement AHRQ’s current work in dissemination and implementation? PCORI's Blueprint for a Dissemination and Implementation Action Plan 139 2
  • 140. #PCORI What key elements would you like to see in PCORI’s Blueprint to help your organization with implementing research findings? PCORI's Blueprint for a Dissemination and Implementation Action Plan 140 3
  • 141. #PCORI Housekeeping and Break 2:30 pm – 2:45 pm 15 Minutes 141 • Visit us at www.pcori.org • Follow @PCORI on Twitter • Watch our YouTube channel PCORINews PCORI's Blueprint for a Dissemination and Implementation Action Plan
  • 142. #PCORI Roundtable Discussion - Part 2: Questions 4, 5, and 6 90 Minutes 142PCORI's Blueprint for a Dissemination and Implementation Action Plan
  • 143. #PCORI 143 Discussion Questions 4 5 6 What is the best approach to develop a framework for implementing results of comparative effectiveness research (CER)? Which already existing frameworks would you recommend be reviewed for developing PCORI’s blueprint for dissemination and implementation? What would you include in the scope of work for the request for proposal (RFP)? What are the key abilities we should seek among applicants interested in developing a framework in response to the request for proposal (RFP)? PCORI's Blueprint for a Dissemination and Implementation Action Plan
  • 144. #PCORI We Want to Hear From You Current Knowledge and Practice New Investments in Knowledge Implementation Gap to Improve Practice 144PCORI's Blueprint for a Dissemination and Implementation Action Plan Today’s webinar participants can provide input via: Email: implementation@pcori.org Twitter: #pcori The webinar “chat” feature Answer the discussion questions online: http://pcori.org/events/dissemination-and- implementation-roundtable
  • 145. #PCORI What is the best approach to develop a framework for implementing results of comparative effectiveness research (CER)? PCORI's Blueprint for a Dissemination and Implementation Action Plan 145 4
  • 146. #PCORI Which already existing frameworks would you recommend be reviewed for developing PCORI’s blueprint for dissemination and implementation? PCORI's Blueprint for a Dissemination and Implementation Action Plan 146 5
  • 147. #PCORI What would you include in the scope of work for the request for proposal (RFP)? What are the key abilities we should seek among applicants interested in developing a framework in response to the request for proposal (RFP)? PCORI's Blueprint for a Dissemination and Implementation Action Plan 147 6
  • 148. #PCORI Public Comment Period 4:15 pm – 4:45 pm 30 Minutes If you would like to make a comment, press #7 on your keypad and you will be added to the queue For questions regarding the request for proposal (RFP) please view our FAQ page: http://www.pcori.org/assets/PCORI-August-2013-Funding- Announcement-FAQs-0528132.pdf 148PCORI's Blueprint for a Dissemination and Implementation Action Plan
  • 149. #PCORI Next Steps & Adjourn PCORI's Blueprint for a Dissemination and Implementation Action Plan 149
  • 150. #PCORI Closing Remarks – 15 minutes Anne C. Beal, MD, MPH Deputy Executive Director Chief Officer for Engagement A pediatrician and public health specialist, Anne C. Beal, MD, MPH, has devoted her career to providing access to high- quality health care. As PCORI’s first Chief Officer for Engagement, she will work to ensure the voices of patients and other stakeholders are reflected in our growing research portfolio. In her previous role as Chief Operating Officer, she worked to ensure PCORI develops the structure and capacity needed to carry out its mission as the nation’s largest research institute focused on patient-centered outcomes research. She joined PCORI from the Aetna Foundation, the independent charitable and philanthropic arm of Aetna Inc. She holds a BA from Brown University, an MD from Cornell University Medical College, and an MPH from Columbia University. 150PCORI's Blueprint for a Dissemination and Implementation Action Plan
  • 151. #PCORI We Still Want to Hear from You We welcome your input on today’s discussions We are accepting comments and questions for consideration on this topic through July 31, 2013 at 5 PM (ET)  E-mail (implementation@pcori.org)  Respond to discussion questions at: http://pcori.org/events/dissemination-and- implementation-roundtable/ We will take all feedback into consideration 151PCORI's Blueprint for a Dissemination and Implementation Action Plan
  • 152. Thank You for Your Participation